title: Predictive value of phosphorylated axonal neurofilament subunit H for clinical outcome in patients with acute intracerebral hemorrhage.
abstract: BACKGROUND
  Phosphorylated axonal neurofilament subunit H (pNF-H) is a biomarker of axonal injury. We investigated whether plasma pNF-H concentrations were associated with 6-month clinical outcomes and early neurological deterioration (END) of patients with acute intracerebral hemorrhage.
  
  
  METHODS
  Plasma pNF-H concentrations of 112 patients and 112 healthy individuals were quantified by ELISA. Unfavorable outcome was defined as modified Rankin Scale score >2. Associations of plasma pNF-H concentrations with END, 6-month mortality and unfavorable outcome were evaluated.
  
  
  RESULTS
  Plasma pNF-H concentrations were increased in patients than in healthy individuals [700.2 (430.8) pg/ml vs. 25.5 (32.4) pg/ml, P<0.001]. A logistic regression analysis selected plasma pNF-H concentration as an independent predictor for 6-month mortality [OR: 1.287, 95% CI: 1.140-1.524, P<0.001], 6-month unfavorable outcome (OR 1.265, 95% CI 1.121-1.517, P<0.001) and END (OR 1.246, 95% CI 1.109-1.498, P<0.001). A receiver operating characteristic curve analysis showed that plasma pNF-H concentration predicted 6-month clinical outcomes and END with high area under curves (all P<0.001). The predictive value of pNF-H was similar to that of the National Institutes of Health Stroke Scale score (all P>0.05). In a combined logistic-regression model, pNF-H did not improve the predictive value of National Institutes of Health Stroke Scale score (all P>0.05).
  
  
  CONCLUSIONS
  Increased plasma pNF-H concentration was highly associated with 6-month clinical outcomes and END of patients with intracerebral hemorrhage.
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Jian-Yong
authors.initials: JY
authors.lastname: Cai
authors.forename: Chuan
authors.initials: C
authors.lastname: Lu
authors.forename: Mao-Hua
authors.initials: MH
authors.lastname: Chen
authors.forename: Hua-Jun
authors.initials: HJ
authors.lastname: Ba
authors.forename: Xian-Dong
authors.initials: XD
authors.lastname: Chen
authors.forename: Jian-Hu
authors.initials: JH
authors.lastname: Lin
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016900:Neurofilament Proteins / Q000097:blood*; D010766:Phosphorylation; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D016900:Neurofilament Proteins; C051774:neurofilament protein H
keywords: Early neurological deterioration; Intracerebral hemorrhage; NIHSS; National Institutes of Health Stroke Scale; Neurofilament; Outcome; Phosphorylated axonal neurofilament subunit H; Stroke; mRS; modified Rankin Scale; pNF-H